If untreated, it can lead to mental and emotional problems, and sometimes, suicide.
Dutch researcher Peggy Cohen-Kettenis estimates that 40% of untreated transsexual people are either institutionalized or die prematurely.
An older term, sex change surgery may be seen as disrespectful.
The entire process of switching from one physical and social gender presentation to the other is often referred to as transition, and usually takes several years.
The transition process can be highly traumatic and may involve the person being off work for a long period of time. To obtain sex reassignment therapy, transsexual people are usually required to receive psychological therapy and a diagnosis of gender identity disorder.
Transsexualism is considered a taboo subject in many parts of the world.
The justifications for negative beliefs about transsexualism may be perceived as being supported by religious beliefs or cultural norms.